Coding Quality Auditor
Children's Healthcare of Atlanta
Outpatient Facility Coding Auditor
Ensemble Health Partners
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $57,400 - $99,000 per year
Job Level
Mid-LevelSenior
About the role
- Audit the quality of all outpatient work types to assure appropriateness and accuracy of Diagnoses, CPT, HCPCS, CCI edits, and modifier assignment
- Apply ICD10CM, CPT, HCPCS, CPT Assistant, Coding Clinic, CMS guidelines, and NCCI to substantiate coding decisions
- Participate in client system education to gain knowledge necessary to audit client accounts
- Maintain meticulous documentation, spreadsheets, account, and claim examples of root cause issues
- Perform searches of governmental, payor-specific, hospital-specific, regulatory body, and literature rules and guidelines to identify coding and billing requirements
- Make recommendations to client based on audit findings
- Assist in development and coordination of executive summary reports, education and training, and client coding companion
- Meet established productivity standards for coding audits
- Attend coding conferences, workshops, and in-house sessions to receive updated coding information and regulatory changes
- Provide excellent customer service in an organized and efficient manner while maintaining a positive attitude
Requirements
- 3+ years of outpatient facility coding experience
- 3+ years of auditing experience
- Advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements
- Knowledge of ICD10CM, CPT, HCPCS, CCI edits, modifier assignment, NCCI, CPT Assistant, Coding Clinic, CMS guidelines
- Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation
- Ability to clearly communicate medical information to professional practitioners and/or the general public
- Ability to adapt and modify medical billing procedures, protocol, and data management systems
- Ability to provide guidance and training to professional and technical staff
- Competent with Microsoft Office applications, including Word, Excel, and PowerPoint
- Meet established productivity standards for coding audits & coding certification requirement
- Minimum Education: High School Diploma or GED required
- Certifications: Must have and keep current at least one: CPC, CCS (preferred), RHIA, or RHIT
Benefits
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
- Associate Benefits including healthcare, time off, retirement, and well-being programs
- Quarterly and annual incentive programs
- Professional certification support and reimbursement
- Recognition programs (quarterly and annual incentives)
- Remote work (Remote - Nationwide)
ATS Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
ICD10CMCPTHCPCSCCI editsmodifier assignmentNCCICPT AssistantCoding Clinicmedical codingbilling systems
Soft skills
excellent customer serviceclear communicationguidance and trainingadaptabilityorganizationattention to detailpositive attitudemeticulous documentationproblem-solvingproductivity
Certifications
CPCCCSRHIARHIT
